February 9, 2018
Erick Mojica – B.S Kinesiology
In a previous post I talked about my new approach with breathing in regards to my training and recovery. As I’ve been applying it to my everyday routine, I have slowly been using the same concept with some of my clients.
Specifically with one client, we had a conversation throughout a full hour training session that has sparked a new thought… How does Thinking and Feeling influence how we train? With a quick background on her (she was totally cool with me sharing this!), she is a woman in her 60’s with a history of lower back and shoulder pain and discomfort.What is unique about her is that she is extremely curious and nearly asks me a thousand questions each session (A bit exaggerated but I love teaching!). Well with such curiosity thinking can get in the way for her to learn new movement patterns, especially with her shoulder mobility.
My approach to a client like her is to first implement motor control into her training. If there are limitations to moving a certain body part, improving its mobility and function is a priority to ensure long term health. If her body moves and feels better, then she can eventually focus solely on strength and rarely have to worry about her muscle and joint discomforts.
With that said, there were a variety of exercises that she initially struggled to figure out. An example is when we began doing Foam Roll Serratus Wall Slides. Here’s a great demonstration by one of my favorite movement specialists – Eric Cressey.
In her initial evaluation I noticed how there was a “kink” in her left shoulder when I asked her to raise her arm and perform a full arm circle. To get a feel for her scapular movement, we began with these Wall Slides and noticed how she had a lot of tension in her neck when she raised her arms to move the Foam Roller up the wall. My reasoning behind this exercise was to figure out how much of her upper back she was able to engage. Ideally with an arm raise, the scapula should rotate smoothly without much trapezius muscle activation. In summary our goal was to teach the muscles in her scapula and mid-upper back to engage, enabling the shoulder and neck muscles to carry less of the load when trying to raise her arms.
While training someone, there are a variety of internal and external cues to give to a person to help them understand what the movement should look like as well as how it feels. An example to teach someone how to activate their upper back is to tell them to “pinch together the shoulder blades” (internal) or “imagine I’m about to tickle you in the upper ribs” (external). Both can help her accomplish the simple task of retracting her scapula and engaging the key muscles to efficiently raise the arms.
Back to the whole concept of Thinking vs. Feeling, I struggled to get her to understand what she needed to do with a lot of exercises. I like to constantly ask my clients “What did you feel?” Well the deep thinker that she is she often answered, “I don’t know!” There was a lot of confusion with many exercises but it was a subject that I could push on her as a trainer simply because she wanted to solve the puzzle too. The more we worked together the more she started to describe what she was feeling. I have a number of ideas why this started happening but a lot of it likely had to do with repetition and her willingness to work on the movement patterns outside of her training sessions with me. In the conversation we had in our most recent session, it all started with the topic of Yoga.
We talked about how the focus of breathing really helped relax her muscles and I briefly talked about my experiences with Yoga. As we started our session with mobility work, we discovered something that has once again sparked my perspective with training.
I like to have my clients with hip and shoulder issues perform CARs (Controlled Articular Rotations). Here is a demonstration from Frank Duffy at Cressey Sports Performance.
The basic concept behind these movement exercises is to gradually push a ball-and-socket joint slightly beyond its joint limitation. So that “kink” in her left shoulder happened every rotation at the point where her arm was pointed behind her back. Well every time we performed this exercise my cue was for her to listen to her shoulder and focus on when she felt that mild discomfort at that point in the movement. Her range of motion improved over time but she still felt that discomfort in the joint. The game changer was when I asked her to treat the exercise like Yoga and breathe through the movement. The concept of pushing the discomfort remained, but the focus was slightly shifted away from listening to her body (thinking) and instead feeling it. What we accomplished was that she felt minimal discomfort.
In my eyes her range of motion improved and even though that “kink” was still there she had no discomfort!!! My hypothesis is that the focus on her breathing distracted her from thinking about the discomfort. The flaw in my notion is that it is very difficult to validate what is physically happening to this individual simply because no one but her can fully understand what she felt. The best study that comes to mind would be to apply EMG (Electromyography) pads on her muscles along with a brain scan to figure out what kind of activity is truly happening. Nevertheless I truly believe that the brain is capable of doing anything… including blocking pain signals.
A theory that fascinates me and has influenced my approach to this pain management concept is Dr. Ramachandran’s “Phantom Limb” study. In a class at Avila called Behavior and the Brain, we had this theory as part of the curriculum to further understand the influences of the brain and what we feel in our body.
Below are some fascinating clips of his work with amputated patients. It is totally worth the watch!!!
In detail, “Phantom Limb” is a phenomenon where a person with an amputated limb continues to feel the body part that is no longer there. In most cases a person with an amputated hand, arm, leg, etc. experiences frequent pains in discomforts that vary in pain levels. Dr. Ramachandran came up with a simple yet brilliant idea of creating a box with a mirror to have a person use the arm that they have and “trick the brain” into thinking that the amputated arm is there after all.
Why is this significant? Well when the body senses pain it is simply a neurological signaling that is connected from the brain to the body part. If you touch a hot stove, your brain responds immediately telling your muscles to contract to remove your finger off. So if your brain is telling you that your shoulder hurts, there should be a way to influence that signaling to either remove or at least decrease the sensation of pain. Fascinating isn’t it?
Well even if you have all of your limbs intact I believe that there is to be a way to create a similar effect when a person has neck pain, shoulder, foot, back, etc. One could say that it is all a psychological fix but that is the point! While breathing may not have had a direct physiological effect onto my client’s tender shoulder, I believe that it had an effect on her brain and how she interpreted that pain signaling. The cause of pain/ discomfort in her shoulder was there, but her controlled breathing took her mind away from it!
So if you experience any kind of chronic pain and discomfort throughout your body, think about what you are thinking. This thinking can help you figure out how not to think and focus on what you are feeling. If you focus on feeling, then the pain you were feeling could decrease or may not even be felt. My mind is crazy… I know! But it is worth a try! So far breathing techniques is what helps me get distracted form the pains in my lower back and hip. Is the damage to my joints still there? Of course, but an approach like this can be very beneficial if you find a way to distract your mind from all your aches and pains. So try both Thinking and Feeling and see if you can trick your brain into removing that pain. If you think hard enough you might just start feeling but not feeling. Feel me?
Special thanks goes out this client for letting me share her story. You have made a huge impact on my career as a Personal Trainer and I thank you!!!